• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.281-289
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• 2023

Purpose : In this study, we aimed to determine how frequencies different of repetitive transcranial magnetic stimulation applied to the less affected contalesional corticomotor area affect upper extremity motor function in patients with acute stroke within 3 months of onset. By doing so, we aimed to propose a new method of rTMS intervention based on the degree of damage and recovery status of the patient, rather than the generalized rTMS intervention that has been used uniformly. Methods : The rTMS intervention was applied on the contralesional side of the cerebral hemisphere damage. 15 subjects in the HF-rTMS group, 12 subjects in the LF-rTMS group, and 14 subjects in the SF-rTMS group were randomized to receive the rTMS intervention in each group for a total of 10 sessions on five consecutive weekdays for two weeks, and underwent FMA-U to determine changes in upper extremity function following the intervention in each group. FMA-U was performed within 24 hours before and after the rTMS intervention. Results : When the FMA-U was performed to determine the pre- and post-intervention changes in upper extremity motor function within the groups, no statistically significant differences were found in the SF-rTMS group before and after the intervention, but significant statistical differences were found in the HF-rTMS group (p=.006) and the LF-rTMS group (p=.020), with greater significance in the HF-rTMS group than the LF-rTMS group. Conclusion : This study confirmed that compensatory action by activating the less affected contralesional corticomotor area based on the bimodal balance-recovery model can support upper extremity recovery patients with acute stroke within 3 months of onset, depending on the degree of damage level and recovery status. Therefore, the results of the contralesional HF-rTMS application in this study may provide a basis for proposing a new rTMS intervention for upper extremity recovery in stroke patients.

• Safety and Health at Work
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• v.1 no.2
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• pp.158-166
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• 2010

Objectives: This study aimed to find gender distinctions in terms of the sociology of the population; to determine work-related factors; to analyze gender differences in daily living, work, sports, and art performances; and to identify gender-related factors that limited performance of daily living and work activities. Methods: A questionnaire was designed that included disabilities of the arm, shoulder, and hand (DASH), accident history, disease history, work duration at current workplace, marital status, job satisfaction, job autonomy, and physical demands of the job. Out of 1,853 workers surveyed, 1,173 questionnaires (63.3%; 987 males, 186 females) included responses to DASH disability and DASH optional work and were judged acceptable for analysis. Results: Upper extremity functional limitation during work and daily living was higher for females than males. The limitations for males increased according to their household work time, accident history, work duration, job satisfaction, physical demand, and job autonomy. Meanwhile, female workers' upper extremity discomfort was influenced by their disease history, job satisfaction, and physical demands. In addition, the size of the company affected male workers' upper extremity function, while marriage and hobbies influenced that of female workers. Conclusion: This study addressed sociodemographic factors and work-related factors that affect each gender's upper extremity function during daily living and working activities. Each factor had a different influence. Further studies are needed to identify the effect that role changes, not being influenced by risks at work, have on musculoskeletal disorders.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.115-125
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• 2016

PURPOSE: The purpose of this study was to compare the effects of task-oriented training and virtual reality training on upper extremity function, balance ability, depression in stroke patients. METHODS: Forty stroke patients were randomly allocated into a task oriented training group (TTG, n = 20), a virtual reality training group (VRG, n = 20). Both groups received the usual physical therapy. In addition, TTG patients underwent task training such as sweeping the table, cup stacking, carrying wood block. VRG patients underwent virtual reality training using X-box kinect. Both groups received 30 minutes of training per day, five times per week, for twelve weeks. RESULTS: After intervention, both groups showed significant improvement on upper extremity function, balance ability, and depression. VRG showed more improvement on upper extremity function, balance ability, and depression than TTG. CONCLUSION: According to the results of this study, task-oriented training and virtual reality training are feasible and suitable for stroke patients. And virtual reality training is more effective method than task oriented training.

• The Korean Journal of Rehabilitation Nursing
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• v.18 no.2
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• pp.67-74
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• 2015

Purpose: The purpose of this study was to identify the effects of auricular acupressure therapy on the upper extremity function, perceived health status and Activities of Daily Living for rehabilitation among stroke patients at home. Methods: As a quasi-experimental study, non-equivalent control group pretest-posttest design was used. Data were collected from August 1st to September 31st, 2012. Participants were 28 (Experimental 17, Control 11) stroke patients at home. Using the SPSS/WIN 12.0 program, data were analysed by the $x^2$-test, Fisher's exact test, Mann-Whitney U test and Wilcoxon signed rank test. Results: Upper extremity function (U=28.00, p=.001) and activities of daily living (U=47.50, p=.029) were significantly higher in the experimental group compared to the control group. However, perceived health status was not significantly different between the two group. Conclusion: This study proved that auricular acupressure therapy was effective for upper extremity function and activities of daily living among stroke patients at home.

• Therapeutic Science for Rehabilitation
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• v.5 no.1
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• pp.7-22
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• 2016

Objective : This study was conducted to review about instrument for bilateral upper extremity assessment. Methods : We searched published papers in Medline database. The keywords used in the search were 'upper extremity' and 'motor activity', 'activities of daily living' and 'assessment', 'instrument', 'disability evaluations'. In total of 68 papers, 44 assessment instruments was extracted. We analyzed about numbers, subjects, methods, reliability, validity, responsiveness of assessment instruments about bilateral upper limb function comparing unilateral, combined bilateral and unilateral instruments. Results : The numbers of bilateral measurement tool were 2 in a total of upper extremity measurement tools. Also, subjects were patients with stroke and measurement was based on performance. The reliability, validity and responsiveness of tools were high. Conclusions : Futher study will be needed to development and research about instrument of bilateral upper extremity.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.133-140
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• 2016

PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.

• The Journal of the Korea Contents Association
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• v.20 no.6
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• pp.114-123
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• 2020

The purpose of this study was to determine the effect of lower extremity strengthening program on balance, gait and upper limb function in patients with stroke. This study was a hospital-based with Central nerve system lesion patients, randomized controlled trial with a blinded assessor. Twenty four hemiparetic stroke patients were divided into two groups: a Lower extremity strengthening program group (LESPG)(n=12) and a Treadmill training group (TTG)(n=12). The LESPG performed a Lower extremity strengthening program on the affected side. The TTG exercised on a treadmill for 30 minutes a day. Assessment tools included the Timed Up and Go test (TUG), the Functional Gait Assessment (FGA) and the Manual Function Test (MFT). There was a significant difference in TUG, FGA, and MFT scores between the two groups in the LESPG for the balance, gait, and upper limb function than for the TTG(p<.01). Results of the present study indicated that the effect of lower extremity strengthening program for 4 weeks had an effect on balance, gait and upper limb function of hemiplegic patients after stroke.

• PNF and Movement
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• v.20 no.2
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• pp.147-156
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• 2022

Objective: Electrical stimulation is an assistive technology used to aid the recovery of upper limb use after stroke. The purpose of this systematic review was to determine the effects of electrical stimulation on upper extremity function in individuals with hemiparetic stroke and to develop an evidence base that supports the use of electrical stimulation for upper limb recovery after stroke. Design: A systematic review based on randomized controlled trials (RCTs). Methods: Studies published before April 20 2021 were collected for this review by searching PubMed, four other databases, and RCTs that reported the effects of electrical stimulation on upper extremity function in individuals with the characteristic stroke type. Information on the following parameters was extracted from each study: surname of first author, published year, country, participants, intervention, intervention's intensity, comparison, outcomes, additional therapy, and summary of results. This review also evaluated the bias within each study, including any selection bias, performance bias, detection bias, attrition bias, and reporting bias. Results: This review included five RCTs, and 208 stroke patients were included in the analysis. Stroke patients who underwent electrical stimulation showed significantly improved grip and pinch strengths, wrist range of motion, and basic daily living compared to those in the control group; however, there was no improvement in upper extremity function. Of the selected papers, 60% showed a "high risk" of performance bias, and 20% showed a "high risk" of detection bias. Conclusions: The results of this systematic review suggest that electrical stimulation provides some benefits to stroke patients, such as improved hand strength and range of motion. However, future studies are needed to provide clinical evidence of the effects of electrical stimulation on upper extremity function in stroke patients.

• The Journal of the Korea Contents Association
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• v.20 no.9
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• pp.520-530
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• 2020

The purpose of this study was to investigate the effects of occupation-based bilateral upper extremity training and transcranial direct current stimulation on upper limb function in stroke patients. The study group was divided into 13 experimental groups with occupation-based bilateral upper extremity training and transcranial direct current stimulation, and 13 controls with only occupation-based bilateral upper extremity training. A total of 4 weeks, 50 minutes, 5 times a week conducted, the patients were tested with Canadian Occupational Performance Measure(COPM), Accelerometer, Fugle-Meyer Assessment(FMA), and Motor Activity Log(MAL). As a result of the study, the experimental group and the control group showed significant improvement in both occupation satisfaction and performance, usage of the affected side and the tendon side, recovery of upper limb function, and quality of movement, In particular, the experimental group showed a significant difference in the amount of the affected side than the control group. Therefore, it was found that the combination of occupation-based bilateral upper extremity training and transcranial direct current stimulation had a positive effect on the recovery of upper limb function in stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.115-123
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• 2019

PURPOSE: This study compared the scores of the Mini-Mental State Examination-Korean version (MMSE-K) and Korean version Montreal Cognitive Assessment (K-MOCA), which assess cognitive function, the Fugl- Meyer Upper-Extremity Assessment (FMA), which assess the upper extremity function; and Modified Barthel Index (MBI), which that assesses activities of daily living among patients receiving inpatient treatment following a diagnosis of stroke to determine the correlations among MMSE-K, K-MOCA, FMA, and MBI. METHODS: The study assessed the cognitive function using the MMSE-K and K-MOCA, upper extremity function using FMA, and activities of daily living using MBI. The data were analyzed using Pearson's correlation analysis and multiple regression analysis. RESULTS: An analysis of the differences in the MMSE-K, K-MOCA, MBI, and FMA scores according to the affected side, revealed differences in the, K-MOCA scores according to the affected side, where patients with right hemiplegia showed better cognitive function (p <.05). Correlation analysis among MMSE-K, K-MOCA, FMA, and MBI Showed significant correlations (p <.05). The results indicate that those with higher cognitive and upper extremity functions had higher performance of activities of daily living. CONCLUSION: The cognitive and upper extremity functions were correlated with the activities of daily living in stroke patients. Accordingly, applying physical therapy with a focus on improving the cognitive function and training activities of daily living could assist in the functional recovery of stroke patients significantly.